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DEATH
CERTIFICATE
ERVAN TACKITT
Date 01 August 1922
Cert: 17696
Place of Death: Vot. Precinct: Antioch, Beaver, Floyd
Co., Ky.
Full Name: Ervan TACKITT
Sex, Color or Race, Marital Status: Male, White, (blank)
Date of Birth: 08 October 1921
Age: 01 years, 07 months
Occupation: (blank)
Birthplace: Beaver, Ky.
Name of Father: George TACKITT
Birthplace Father: Ky.
Maiden name of Mother: Beccie BENTLEY
Birthplace Mother: Ky.
Informant/Address: (blank)
Filed: 10 August 1922
Registrar: Mary A. Vance
Death Date: 01 August 1922
I hereby certify that I attended deceased from 02 August 1922, to
02 August 1922, that I last saw him alive on 02 August 1922,
and that death occurred, on the date stated above, at 11 a.m.
Cause of Death: hemorrhage of the bowles [sic]
Duration: (blank)
Contributory: (blank)
Signed/Address: (blank)
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: Tackitt Graveyard
Date of Burial: 03 August 1922
Undertaker/Address: Andy Tackitt, Beaver, Ky.
Transcribed by Debbie Tamborski, 19 March 2010 |
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